| Name: | Anniston Gastroenterology Associates, P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Exists |
| Date of registration: | 07 Nov 2001 (23 years ago) |
| Entity Number: | 000-219-627 |
| Register Number: | 000219627 |
| County: | Calhoun |
| Place of Formation: | Calhoun County |
| Principal Address: | ANNISTON, AL |
| Registered Office Street Address: | 1730 LEIGHTON AVEANNISTON, AL 36201 |
| Registered Office Street Address ZIP Code: | 36201 |
| Authorized Capital: | $1,000 |
| Paid Share Capital: | $1,000 |
Activities
PRACTICE MEDICINE
| Unique Entity ID | Expiration Date | Physical Address | Mailing Address | |||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| VQUNLNG7DGH3 | 2021-11-04 | 1720 LEIGHTON AVE, ANNISTON, AL, 36207, 3811, USA | 1720 LEIGHTON AVE, ANNISTON, AL, 36207, USA | |||||||||||||||||||||||||||||||||||||
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| Doing Business As | (AFF: ANNISTON HMA) |
| Congressional District | 03 |
| State/Country of Incorporation | AL, USA |
| Activation Date | 2020-06-01 |
| Initial Registration Date | 2020-04-16 |
| Entity Start Date | 2002-01-01 |
| Fiscal Year End Close Date | Dec 31 |
Points of Contacts
| Electronic Business | |
|---|---|
| Title | PRIMARY POC |
| Name | PANKAJ KASHYAP |
| Address | 1720 LEIGHTON AVE, ANNISTON, AL, 36207, USA |
| Government Business | |
|---|---|
| Title | PRIMARY POC |
| Name | PANKAJ KASHYAP |
| Address | 1720 LEIGHTON AVE, ANNISTON, AL, 36207, USA |
| Past Performance | Information not Available |
|---|
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1083764526 | 2007-01-10 | 2009-04-21 | PO BOX 126, ANNISTON, AL, 362020126, US | 1720 LEIGHTON AVE, ANNISTON, AL, 362073811, US | |||||||||||||||||||||||||
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| Phone | +1 256-237-3284 |
| Fax | 2562374104 |
Authorized person
| Name | HOLLY BENEFIELD |
| Role | OFFICE MANAGER |
| Phone | 2562373284 |
Taxonomy
| Taxonomy Code | 174400000X - Specialist |
| License Number | 19468 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 529909260 |
| State | AL |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ANNISTON GASTROENTEROLOGY ASSOCIATES 401(K) PLAN | 2009 | 631286628 | 2010-09-14 | ANNISTON GASTROENTEROLOGY ASSOCIATES | 5 | |||||||||||||||||||||||||||||||||||||
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| Administrator’s EIN | 631286628 |
| Plan administrator’s name | ANNISTON GASTROENTEROLOGY ASSOCIATES |
| Plan administrator’s address | 1720 LEIGHTON AVENUE, ANNISTON, AL, 36207 |
| Administrator’s telephone number | 2562373284 |
Signature of
| Role | Plan administrator |
| Date | 2010-09-14 |
| Name of individual signing | PANKAJ K. KASHYAP, M.D. |
| Role | Employer/plan sponsor |
| Date | 2010-09-14 |
| Name of individual signing | PANKAJ K. KASHYAP, M.D. |
| Name | Role |
|---|---|
| KASHYAP, PANKAJ | Agent |
| Name | Role | Address |
|---|---|---|
| KASHYAP, PANKAJ | Incorporator | No data |
| PATEL, HARSHAD | Incorporator | 15 JAY CTBOHEMIA, NY 11716 |
| HOPKINS, VIRGINIA | Incorporator | No data |
Date of last update: 01 Aug 2024
Sources: Alabama Secretary of State
